tbuckley/cabot-search huggingface dataset:
AB0436 THE IMPROVEMENT OF THE DAS28 SCORE AT THREE MONTHS PREDICTS BIOLOGIC DRUGS TOLERANCE AND SURVIVAL IN RHEUMATOID ARTHRITIS
Authors: S. Boussaid, M. Hassayoun, S. Rekik, S. Rahmouni, K. Zouaoui, H. Ajlani, H. Sahli, M. Elleuch
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The treat-to-target strategy has been established as a guiding principle for the treatment of rheumatoid arthritis (RA). Nevertheless, data on the degree to which the improvement of the DAS28 score impacts the survival of biologic drugs is rarely studied. <h3>Objectives</h3> Our objective in this study was to assess the influence of the improvement of the DAS28 score at 3 months on biologics tolerance and survival. <h3>Methods</h3> We conducted a cross-sectional and observational study. Files of patients with RA on biologics drugs (archived from the files of patients on the National Health Insurance Fund of Tunis) were studied. Epidemiological characteristics such as age, sex, and comorbidities, were collected. RA activity was assessed by the composite score 'Disease Activity Score 28' (DAS28). Patient follow-up was done at 3 months by the DAS28 disease activity score. We specified the ΔDAS28, between the initiation of biotherapy and the value at 3 months. The therapeutic maintenance rate at 3 months as well as the biologics survival was analyzed using Kaplan-Meier survival curves and compared using the Log-Rank test. <h3>Results</h3> Three hundred and seventy-four files were selected. The average age of our cohort was 55±12.54 years [20-90]. A female predominance was noted with a sex ratio M/F=0.147. The average duration of RA was 11.7±6.76 years [2-41]. The first biotherapy prescribed was certolizumab pegol 13%, adalimumab in 14% of cases, infliximab 6%, tocilizumab 6%, etanercept in 54% of cases, and rituximab in 7% of cases. The average DAS28 at the initiation of the biological treatment was 6.02 ± 0.89. The median was 6 [5.37–6.50]. We noted that the higher the delta DAS28 at 3 months of treatment, the lower the risk of interrupting the biological treatment, as evidenced by the HR = 0.709 (p &lt; 10-3). For patients with a moderate to good response the maintenance rate was 45.35 months [43.06-47.64]; for patients with no response; therapeutic maintenance was 28.55 months [22.41-34.69]. <h3>Conclusion</h3> Efficient and rapid management of RA remains the most appropriate strategy to achieve control of the disease. The rapid improvement of DAS28 under biologics would be, according to our results, a factor influencing the survival of these treatments. Larger-scale studies will be needed to confirm these results. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0388 RHEUMATOID ARTHRITIS WITH CONCOMITANT FIBROMYALGIA: THE ROLE OF ULTRASOUND IN ASSESSING DISEASE ACTIVITY
Authors: S. Miladi, B. A. Hiba, F. Alia, H. Bousaa, M. Yasmine, L. Souabni, K. Ouenniche, K. Selma, C. Selma, K. Ben Abdelghani, L. Ahmad
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Fibromyalgia (FM) is a chronic painful condition frequently associated with rheumatoid. arthritis (RA) which may falsely increase RA activity by modifying the subjective components. of disease activity scores. <h3>Objectives</h3> The aim of our study was to compare clinical scoring and ultrasound (US) assessment in RA patients with concomitant FM to RA patients without FM. <h3>Methods</h3> Cross-sectional study that included patients with diagnosis of RA (ACR/EULAR 2010 criteria) with concomitant FM (ACR 2016) and to compare it to RA patients without FM. Demographic and RA characteristics were collected. US examination of 22 joints was blindly performed by a single physician. US-detected synovitis was defined and scored 0-3 using the OMERACT scoring system at the joint level for both grey-scale (GS) and Doppler power (DP). The number of joints with ≥ grade 1 GS synovitis and those with ≥ grade 1 DP were calculated. Multiple linear regression analysis performed, adjusting for clinical and demographic variables. <h3>Results</h3> Eighty patients distributed into 40 patients in each group were recruited. Epidemiological characteristics and RA characteristics were comparable between groups. Biologic DMARDs prescription was more frequent in RA with FM patients than control group (p=0.04). Subjective activity parameters were higher in RA with FM group (p&lt;0.05). DAS28 was significantly greater than DAS28 V3 in RA with FM group (p=0,000). FM group had significantly less US synovitis (p=0.035) and less Power Doppler (PD) activity (p=0.035). Grey scale (GS) US score (p=0.87) and DP US score (p=0.162) were similar in the two groups. Multivariate analysis in RA with FM group showed that DAS28 V3 and male gender were positively associated with the presence of US synovitis, while Patient Global Activity expressed a negative association. <h3>Conclusion</h3> Our study confirms the overestimation of disease activity by the clinical scores in RA with concomitant FM. DAS28 V3 score and US assessment would represent a better alternative. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0399 EFFICACY AND SAFETY OF ABATACEPT IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: B. R. Zhao, T. Chen, J. T. Zhang, N. Zhu, Q. Y. Su, Q. Yu, P. F. He, X. LI, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis(RA) is a systemic inflammatory disorder that mainly affects the diarthrodial joint. Abatacept was approved by the US Food and Drug Administration (FDA) in December 2005 for use in RA<sup>[1,2]</sup>. <h3>Objectives</h3> This study aimed to systematically evaluate the efficacy and safety of abatacept therapy in RA. <h3>Methods</h3> Eight databases (PubMed, Web of Science, Embase, Cochrane Library, Web of Knowledge, MEDLINE, Clinical Trials.gov, and FDA.gov) were searched for studies on abatacept treatment of RA published from the date of establishment of the database to January 1, 2022. A random effect model was used to conduct a meta-analysis of the efficacy and safety of abatacept in patients with RA using (Stata 12.0). <h3>Results</h3> The DAS28-CPR of RA receiving abatacept therapy at 24 weeks was significantly decreased compared with the baseline[SMD= -1.624, 95%CI -1.903 - -1.345, P&lt;0.01]. After receiving abatacept therapy for 24 weeks, patients with RA had a significantly decreased in DAS28-ESR [SMD= -1.067 (95% CI: -1.399 - -0.735), P&lt;0.01], SDAI [SMD= -1.484 (95% CI: -2.167 - -0.802) P&lt;0.01], and CDAI [SMD=-1.726 (95% CI: -2.671 - -0.781), P&lt;0.01] compared with the baseline. The incidence of adverse events was 58.7%. The incidence of serious adverse events was 8.7%. General infection is a typical effect of abatacept, occurring in 25.2% of RA. Most of these adverse events were mild and recovered quickly after discontinuation. Besides, severe infection occurred in 2.3 % of RA (Figure 1). <h3>Conclusion</h3> Abatacept was effective and well-tolerated in RA patients. The incidence of adverse events was high, but most were mild and recovered quickly after discontinuation. <h3>References</h3> [1] Maxwell L, Singh JA. Abatacept for rheumatoid arthritis. The Cochrane database of systematic reviews. 2009;2009(4):CD007277. [2] Lee DM, Weinblatt ME. Rheumatoid arthritis. Lancet. 2001;358(9285):903-11. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0359 SALIVARY ULTRASONOGRAPHY AND HISTOPATHOLOGIC EVALUATION OF SECONDARY SJÖGREN’S SYNDROME IN RHEUMATOID ARTHRITIS PATIENTS
Authors: Y. Park, M. Oh, B. W. Lee, E. J. Kwon, Y. S. Lee, W. U. Kim
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Novel modalities, such as salivary ultrasonography (SGUS) and shear wave elastography (SWE), have previously been introduced to evaluate Sjögren's syndrome (SS). However, in secondary SS (sSS), the diagnostic performance of SGUS and its relationship with clinicopathological characteristics have not yet been clearly defined. <h3>Objectives</h3> In this study, we aimed to investigate sSS in RA patients using SGUS and SWE and sought to determine its pathological correlations. <h3>Methods</h3> Thirty-one RA patients who presented with sicca symptoms were included to be evaluated on SS, and were compared with 18 primary SS (pSS) patients. All subjects were assessed through SGUS and SWE, as well as conventional diagnostic approaches for SS, including minor salivary gland biopsy (MSGB). In SGUS evaluation, two separate scoring systems, suggested by Hocevar and OMERACT, were used. <h3>Results</h3> Among 31 RA patients with sicca symptoms, 19 (61.2%) were diagnosed as sSS. RA patients with sSS showed significantly lower positivity for anti-Ro/La antibody than did pSS patients. Similar to pSS, SGUS showed good diagnostic performance in differentiating sSS from RA patients with simple sicca symptoms. The sSS and pSS patients exhibited significantly higher lymphoid infiltration areas in MSGB than RA patients without SS. Focus score and lymphoid infiltration areas correlated well with sonographic severity. The severity of fibrosis in MSGB showed better positive correlation with SWE than with SGUS. <h3>Conclusion</h3> sSS is frequent in RA patients and presents with less positivity for anti-Ro/La antibodies than does pSS. Similar to pSS, SGUS and SWE show good diagnostic performance for sSS, reflecting histopathologic severity well in MSGB. <h3>References</h3> [1] Jousse-Joulin S, Milic V, Jonsson MV et al. Is salivary gland ultrasonography a useful tool in Sjögren's syndrome? A systematic review. Rheumatology (Oxford) 2016;55:789-800. [2] Mossel E, van Ginkel MS, Haacke EA et al. Histopathology, salivary flow and ultrasonography of the parotid gland: three complementary measurements in primary Sjögren's syndrome. Rheumatology (Oxford) 2022;61:2472-82. [3] Arslan S, Durmaz MS, Erdogan H, Esmen SE, Turgut B, Iyisoy MS. Two-Dimensional Shear Wave Elastography in the Assessment of Salivary Gland Involvement in Primary Sjögren's Syndrome. J Ultrasound Med 2020;39:949-56. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0160 GUT MICROBES AND SYSTEMIC SCLEROSIS: CAUSE OR CONSEQUENCE?
Authors: J. Hou, K. Fan, Y. Zhang, Q. Yu, P. F. He, X. Li, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> There is growing evidence supporting an association between gut microbiota and the risk of systemic sclerosis (SSc)[1]. However, the causal relationship between gut microbiota and SSc remains ambiguous. <h3>Objectives</h3> A two-sample Mendelian randomization (MR) analysis was performed to reveal the causal relationship between gut microbiota and SSc. <h3>Methods</h3> We obtained data on intestinal flora from the MR-base website [2] and 218,499 samples for systemic sclerosis from the IEU database for a two-sample MR analysis. Inverse variance weighting, MR-Egger, and weighted median were used to examine the causal relationship between gut flora and SSc. Then a series of sensitivity analyses were performed to verify the robustness of the results. Finally, the bacteria which appeared causality with SSc were subjected to reverse MR analysis to assess the possibility of reverse causality. <h3>Results</h3> Inverse variance-weighted estimates indicated that genus <i>Collinsella</i> (odds ratio(OR) = 8.982, 95% confidence interval(CI): 1.571-51.366,P = 0.014), phylum <i>Actinobacteria</i> (OR = 5.746, 95% CI: 1.247-26.491,P = 0.025), genus <i>Ruminococcaceae</i> (OR = 5.500, 95% CI: 1.477-20.477,P = 0.011) had a risk effect on SSc (<b>Table 1</b>). According to the results of the reverse MR analysis, SSc had no significant causal effect on intestinal flora. No significant heterogeneity or horizontal pleiotropy of instrumental variables was found. <h3>Conclusion</h3> The present study revealed a causal relationship between three gut microflora genera and SSc, providing new insights into the mechanisms of gut microbiota-mediated scleroderma development. <h3>References</h3> [1]Lemos, M.P.C., et al., <i>Dysbiosis and Gut Microbiota Modulation in Systemic Sclerosis.</i> J Clin Rheumatol, 2022. <b>28</b>(2): p. e568-e573. [2]Kurilshikov, A. and C. Medina-Gomez, <i>Large-scale association analyses identify host factors influencing human gut microbiome composition.</i> 2021. <b>53</b>(2): p. 156-165. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0303 ASSESSMENT OF SEXUAL DISORDERS IN TUNISIAN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: J. Mahbouba, M. Ardhaoui, M. Ghali, S. Zrour, I. Bejia, M. Touzi, N. Bergaoui
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sexual dysfunction is common in patients with rheumatoid arthritis (RA), but is often under-estimated. <h3>Objectives</h3> The aim of this study was to assess the sexual function and to identify the associated factors of sexual disorders in Tunisian RA patients. <h3>Methods</h3> This is a cross-sectional study conducted in the Rheumatology department of Monastir in Tunisia including patients followed for RA. Functional impact was assessed by the Health Assessment Questionnaire (HAQ) and Rheumatoid Arthritis Quality of Life (RAQoL). Disease activity was evaluated using the DAS28 score. Sexual function was assessed for women by a self-assessment questionnaire: the Female Sexual Function Index (FSFI) including several parameters: desire, arousal, lubrication, orgasm, satisfaction and pain. For men, it was evaluated by the Sexual Health Inventory (SHIM) assessing erectile dysfunction. <h3>Results</h3> One hundred patients were included. There were 85 women and 15 men. The mean age was 55.88 ± 10.5 years. Sixty out of 85 women were sexually active. Thirty-five women (58.3%) had sexual dysfunction (FSFI ≤ 26.55). Lack of arousal and loss of desire were the most reported disorders with mean scores of 2.33 and 2.58 respectively. Among the 15 men, nine were sexually active. Only one men had normal sexual activity. Erectile dysfunction was the most common disorder with a mean score of 11. After statistical anlysis, significant association was found between sexual dysfunction assessed by FSFI and SHIM total scores and increased age (p=0.01 and p=0.005, respectively). More intense pain (visual analog scale) was significantly associated with sexual disability in women and men (p=0.01 and p=0.05, respectively). A significant correlation was found between lower FSFI score and higher disease activity by the DAS28 (p=0.001). Concerning the relationship with RA functional impact: we noted that among women, the alteration of arousal and satisfaction domains of the FSFI were correlated with higher HAQ (p=0.05 and p=0.004, respectively). In men, there was a significant association of lower SHIM score with HAQ and RAQoL (p=0.015 and p=0.001, respectively). However, there was no significant association between sexual dysfunction and the duration of RA progression, biological inflammatory syndrome, joint deformities, sturtural damage or the used treatments. <h3>Conclusion</h3> Our study showed that sexual dysfunction is frequent in women and men with RA, and that these disorders can affect their quality of life. Therefore, the sexual life of RA patients should be considered as one of the important therapeutic targets in the global management of this disease. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0161 EARLY INITIATION OF QUADRUPLE THERAPY IN PATIENTS WITH ANTI-MELANOMA DIFFERENTIATION-ASSOCIATED 5 GENE ANTIBODY-POSITIVE (MDA5) DERMATOMYOSITIS (DM) WITH RAPIDLY PROGRESSIVE INTERSTITIAL LUNG DISEASE (RP-ILD) – A RETROSPECTIVE CASE SERIES
Authors: K. M. Chong, M. MA, F. Teo, P. Cheung
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> MDA5 autoantibodies have been associated with an amyopathic form of dermatomyositis, with a subset developing RP-ILD with high mortality of 50%, despite intensive immunosuppressive therapies like high dose prednisolone, cyclophosphamide and calcineurin inhibitors.<sup>[1]</sup> Tofacitinib and rituximab have also been used as single agents, mainly as salvage therapy. <sup>[2]</sup> <h3>Objectives</h3> We aimed to investigate the role of early use of quadruple therapy (high dose steroids, one dose of cyclophosphamide, tofacitinib, rituximab) in patients with anti-MDA5 Ab-positive DM with RP-ILD. <h3>Methods</h3> This is a retrospective case series involving 4 patients with anti-MDA5 Ab-positive DM with RP-ILD from 2019 to 2021. They were treated with quadruple therapy. Their clinical outcomes including survival and adverse events were evaluated. <h3>Results</h3> At initial diagnosis of RP-ILD, all patients were given pulsed methylprednisolone and 1 dose of cyclophosphamide. Tofacitinib was started within 2 weeks, followed by rituximab. 3 patients achieved clinical and biochemical improvement over time, with reduction of glucocorticoids by 6 months. Of the 4 patients, 1 required ICU stay and died. Severe adverse events were observed, most of which were infective complications. <h3>Conclusion</h3> We report a general improvement of survival in anti-MDA5 Ab-positive DM with RP-ILD when treated early with quadruple therapy. <h3>References</h3> [1]Tsuji H, Nakashima R, Hosono Y, Imura Y, et al. Multicentre prospective study of the efficacy and safety of combined immunosuppressive therapy with high-dose glucocorticoid, tacrolimus, and cyclophosphamide in interstitial lung diseases accompanied by anti-melanoma differentiation-associated gene 5-positive dermatomyositis. Arthritis Rheum 2020; 72(3): 488-98. [2]Kurasawa K, Arai S, Namiki Y, Tanaka A, et al. Tofacitinib for refractory interstitial lung diseases in anti-melanoma differentation-associated 5 gene antibody-positive dermatomyositis. Rheum (Oxford) 2018; 57:2114-19. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0256 ARE CRP/ALBUMINE, PLATELET/LYMPHOCYTE, NEUTROPHIL/LYMPHOCYTE RATIO INDICATORS OF SPONDYLARTHRITIS ACTIVITY?
Authors: Z. Ammor, N. Akasbi, H. Bourkhime, T. Harzy
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Spondylitis is a chronic inflammatory rheumatism that most often affects young adult males. In recent studies it has been reported that the platelet ratio (PLR) and neutrophil lymphocyte ratio (NLR) are important in demonstrating systemic systemic inflammation, the CRP albumin ratio (CAR) has been reported as a marker of of inflammation. <h3>Objectives</h3> Our objective is to study the relationship between the value of CAR, PLR, NLR, and the BASDAI score. <h3>Methods</h3> A cross-sectional study including patients with spondyloarthritis according to ASAS 2009 criteria. For each patient CAR, PLR, NLR and BASDAI score were calculated. <h3>Results</h3> 112 patients were included in this study. The average age was 46.9 (+/- 12.7) years, the sex ratio M/F is 1.29, the mean duration of the disease is 7.8 years, 68.8% of the axial spondyloarthritis are severe, 70.5% of spondyloarthritis are radiographic, the average EVA pain is 61.6, 54.5% of patients have a BASDAI &gt;=4, the average CRP is 30.16, the average SR(sedimentation rate) is 32.77, 41.7% of patientsnhave stage III sacroiliitis, 93.9% have bilateral sacroiliitis. The average CAR is 0.88 (+/-1.84), the mean PLR is 157.6, the mean NLR is 3.32, the mean CAR is of 0.88. In the bivariate analysis, the CAR ratio was significantly associated with BASDAI (p=0.038), CRP is also significantly associated with BASDAI score (p= 0.028). <h3>Conclusion</h3> The CAR can be a practical measurement method in the follow-up of patients with axial spondyloarthritis axial spondyloarthritis because it can be used quickly under routine ambulatory conditions,in correlation with the BASDAI. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0282 NEW INFLAMMATORY MARKER IN RHEUMATOID ARTHRITIS: NEUTROPHIL/LYMPHOCYTE RATIO (NLR)
Authors: H. Hachfi, R. Sarraj, M. Brahem, O. Jomaa, N. E. H. Othman, S. Abdellatif, B. Jebali, Y. Mohamed
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Although neutrophils and lymphocytes play well-established roles in the pathogenesis of Rheumatoid arthritis (RA), their count is most often ignored by clinicians. However, the neutrophil/lymphocyte ratio (NLR) seems to be of great value in the evaluation of disease activity. <h3>Objectives</h3> Our objective is to determine the interest of this ratio and to study its relationship with the other parameters of RA activity. <h3>Methods</h3> Cross-sectional study of 70 patients followed for RA. We performed a biological check-up including a complete blood count (CBC), an ESR and CRP level. A NLR was calculated for each patient. <h3>Results</h3> There were 58 women (82.9%) and 12 men (17.1%) with a mean age of 54.7 ± 13.6 years [19-82]. The mean duration of the disease was 10.1± 9.9 years. Sixteen patients (22.8%) had recent RA (&lt;2 years). The mean DAS 28 ESR was 5.38± 1.48. Thirty-nine patients (55.7%) had high disease activity. The average of ESR and CRP were 59 mmH1± 35 [12-150] and 30.3 mg/l ± 28.6 [0-159], respectively. Anemia of inflammation was observed in 43.3% of cases. Lymphopenia was found in 28.6% of cases, neutropenia in 1.4% and neutrophilic polynucleosis in 17% of cases. The mean of neutrophil/lymphocyte ratio was 3.62±2.68 [0.48-13.26]. It was 3.7 in patients with severe activity and 3.5 in those with low to moderate activity. Statistical analysis found a significant association between this ratio (NLR) and anemia (p=0.003), ESR (p=0.005), CRP (p=0.038) and disease activity assessed by DAS 28 ESR (p=0.04). <h3>Conclusion</h3> Despite the fact that in RA there are few studies evaluating the interest of the NLR, our study concludes that this ratio is considered as an alternative inflammatory biomarker that could be used to assess the disease activity. <h3>References</h3> [1] Lijuan W et al. Neutrophil-lymphocyte, platelet-lymphocyte and lymphocyte-monocyte ratios may not be useful markers to assess disease activity in rheumatoid arthritis: A STROBE-compliant article. Medicine (Baltimore). 2021 Nov;100(45):e27631. [2] Uslu AU et al. Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Int J Rheum Dis. 2015 Sep;18(7):731–5. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.